Migraine Diary: What to Write Down So It Actually Helps

By Laurine NicolettiOctober 9, 202611 min

You have a doctor's appointment in two weeks, and the question is already waiting: "How often do you get them, and how long do they last?" Your mind goes blank. Or you started a migraine diary last spring, wrote down three attacks in great detail, and then never opened it again.

A migraine diary is one of the most useful tools you can have, but only if it is simple enough to keep up and clear enough to read later. This article explains what is worth writing down, which mistakes make a diary useless, whether paper or an app suits you better, and how Mellow keeps the effort down to two taps. It also fits into the bigger picture of preventing migraine, because you cannot work on what you cannot see.

In short

A migraine diary helps your doctor with diagnosis and helps you spot patterns, triggers and whether a treatment is working, according to Mayo Clinic.
The essentials are when an attack starts, how long it lasts, how strong it is, your symptoms, what you took, plus sleep, your cycle and stress.
Keeping it simple matters more than keeping it detailed: the American Migraine Foundation says a journal should not become another stressful task.
Memory is a poor substitute: in a study of 182 people, monthly recall gave lower headache counts than a daily diary.

Why keep a migraine diary at all?

A migraine diary gives you and your doctor facts instead of guesses. There is no blood test or scan that confirms migraine, so Mayo Clinic explains that diagnosis relies on your history, your symptoms and an exam. Your own notes are a big part of that history.

The NHS suggests keeping a diary of your attacks for a few weeks to help with diagnosis. The Migraine Trust adds that a diary helps you recognise triggers and warning signs, check whether your medication is working and show patterns in your attacks. It also notes that keeping one for three months or more helps you and your doctor work out what your triggers might be.

There is another reason, and it is a quiet one. Our memory is not great at counting pain days. In a study of 182 people with migraine, a daily electronic diary recorded an average of 13.7 headache days per 28 days, while a monthly recall questionnaire gave 11.1. In other words, when you try to remember, you probably underestimate.

Which 8 things should you note in your migraine diary?

Note the start, the duration, the intensity, your symptoms, what you took, your sleep, your cycle and your stress. That list covers what the Migraine Trust, the NHS and the American Migraine Foundation mention most often. You do not need all eight every time, but this is the menu.

1. When it started (and what you were doing)

Write the date and approximate time. The NHS also suggests noting what you were doing when the migraine began, which can reveal links you would not guess, like a long meeting or a skipped lunch.

2. How long it lasted

Duration is one of the first things a doctor asks. Mayo Clinic lists when your headaches occurred and how long they lasted as core details. If you wonder what is "normal", our guide on how long a migraine lasts gives the usual ranges.

3. How strong it was

Use a simple scale. The Migraine Trust suggests recording severity as mild, moderate or severe, or from 1 to 10. Pick one system and stick to it, so your numbers stay comparable from month to month.

4. Your other symptoms

Nausea, sensitivity to light or sound, dizziness, or visual changes such as an aura all belong here. Mayo Clinic specifically mentions visual disturbances or unusual sensations. A few words are enough: "nausea, light bothers me, zigzag lines before".

5. What you took and whether it helped

Write the name of the medicine or the self-care you tried, when you took it, and whether it made a difference. The Migraine Trust also suggests noting side effects and any second dose. This is information for your doctor, who decides what suits you. It also shows how often you reach for pain relief, which matters because taking pain relievers often can itself cause headaches, something worth discussing with a professional.

6. How you slept

The American Migraine Foundation lists when you sleep among the things to record. Note roughly what time you went to bed and woke up, and whether the night was rough. If you often wake up with a headache, our article on migraine and sleep explains why.

7. Where you are in your cycle

If you have periods, note the first day of each one. The NHS says it may help to write down when your period starts, as this can help your GP identify potential triggers. For the full picture, see migraine and periods.

8. Your stress level

Stress is one of the most commonly reported triggers, and it is also one of the hardest to remember afterwards. A quick "high / medium / low" for the day is plenty. Our article on stress and migraines looks at how the two feed each other.

What other triggers can you track without overdoing it?

Add food, screens and weather only if they feel relevant to you, and keep them to a single word. The American Migraine Foundation mentions diet, environmental factors and weather as useful things to record.

Food and drinks: note skipped or late meals, alcohol and caffeine rather than a full food diary. See migraine and food for what research can and cannot say.
Screens: a very long screen day or a glaring monitor can be worth a quick note. Our article on migraine and screens explains what is known about blue light.
Weather and pressure: a smartphone-diary study found that low barometric pressure, pressure changes, higher humidity and rainfall were associated with more headache occurrences. This is the one trigger you do not need to guess, since it can be recorded automatically. More in barometric pressure and migraines.

A word of caution: a diary shows associations, not proof. Researchers note that patient-reported triggers are not always reliable, and picking out true triggers can need careful analysis over time. Our guide to identifying your migraine triggers shows how to read your notes without jumping to conclusions.

Which mistakes make a migraine diary unusable?

A diary fails when it is too heavy, too vague or too irregular. These are the usual culprits.

Trying to record everything. Long forms feel thorough, but they are quickly abandoned. The Migraine Trust advises that it is often best to keep it simple and record basic information.
Writing it all up days later. The further you get from the attack, the more your memory fills in the blanks. Studies note that smartphone diaries can limit recall bias by allowing entries only for a defined recent period.
Only noting the bad days. A diary full of attacks and no calm days cannot show what is different on the good ones. The American Migraine Foundation suggests noting the presence or absence of head pain, even if some people only update it on headache days.
Changing the scale. If a "6" means one thing in March and another in May, your trends will be blurry. Choose mild/moderate/severe or 1 to 10, and keep it.
Skipping the end time. Start without end gives no duration, and duration is what your doctor will ask for first.
Leaving out medication. Your doctor needs to see what you took and whether it worked, so write it down even if it feels minor.
Giving up after two weeks. Patterns take time. The NHS suggests a few weeks at minimum, and the Migraine Trust points to three months or more for triggers.
Drawing conclusions too fast. One chocolate bar before one attack proves nothing. Look for what repeats.

Paper diary or app: which one should you choose?

Choose the one you will actually open, because the best diary is the one you keep up. Both formats work, and they have different strengths.

Paper is calm, private and free. You can print a headache diary template or keep a simple calendar. The American Migraine Foundation even describes a "stoplight" calendar using green, yellow and red markers for mild, moderate and disabling days. The downside: it is hard to spot trends, you must remember to carry it, and it is easy to forget when you feel awful.

An app is already in your pocket, can add the date and time for you and can turn entries into charts. A review of electronic headache diaries reports that they offer reduced recall bias, easy access for doctors and patients, and improved compliance. The American Migraine Foundation also notes that many headache providers prefer smartphone tracking. The downside: you need to be comfortable with your phone and with where your health data lives.

Whatever you choose, bring it to your appointment. A clear month of notes is often more useful to a doctor than a long story told from memory.

How does Mellow cut the effort down to two taps?

Mellow is a calm, free migraine tracker for iPhone and Android, designed so that logging an attack takes two taps, even in the middle of a bad day. The goal is not to turn you into a data analyst. It is to make sure the essentials are there when you need them.

Here is what it does for the items above:

Quick logging: record an attack in two taps, then add details later if you feel like it.
Triggers: note stress, sleep, screens, cycle and food as they apply, without filling in a long form.
Barometric pressure: tracked automatically, so there is nothing to remember or look up.
Statistics and history: a calendar, plus duration, intensity and trends, so you can see how your month really looked.
A report for your doctor: your history in a form you can bring to an appointment.
Courses: short lessons to understand, prevent and manage migraine.

Mellow does not diagnose anything or tell you what to take. It simply gives you a clear record, and your doctor does the rest with you.

Where should you start this week?

Start small: for the next seven days, note only the start time, the duration and the intensity of any attack. Add one more detail, such as sleep or stress, once that feels easy. Then, after three or four weeks, look at your calendar and ask yourself what repeats.

If something worries you, such as a sudden, very severe headache or new symptoms, do not wait for a diary to tell you. Read when to go to the ER for a migraine or speak to a healthcare professional. And if your notes show patterns you want to act on, the Living with migraine section of the blog is a good next step.

Frequently asked questions

What should I write in a migraine diary?

Start with the date and time, how long the attack lasted, how strong it was, your symptoms and anything you took. The NHS also suggests noting what you were doing when it began and, if relevant, your period. Sleep, stress and weather can be added once the basics feel easy.

How long should I keep a migraine diary?

The NHS suggests a few weeks to help with diagnosis. The Migraine Trust says that three months or more helps you and your doctor work out what your triggers may be.

Is a migraine app better than a paper diary?

Neither is better for everyone. Research on electronic diaries points to less recall bias and easier sharing with your doctor, while paper is calm and needs no phone. The best choice is the one you will use on a bad day.

Can a migraine diary diagnose migraine?

No. A diary cannot diagnose anything by itself, and Mayo Clinic notes that there is no lab or imaging test that confirms migraine. What it does is give your doctor a clear picture of your history, which is a key part of the diagnosis.

Should I note every single headache, even mild ones?

It helps to note them, in a few words. The American Migraine Foundation says you can note the presence or absence of head pain or other symptoms each day, or only update the journal on headache days if that is more realistic for you. A short note is better than a perfect one you never write.

Sources

Written by Laurine Nicoletti, founder of Mellow, who has lived with migraine since she was 21. Learn more · How we write our articles

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